Individual provider Active NPI

Susan Olsen, PA

  • Medical Physician Assistant
  • New Canaan, CT
National Provider Identifier
1013195551
Registry record updated Mar 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3806 Issued in CT
Practice address
22 Pine St
New Canaan, CT 06840-5408
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Feb 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0002509 MD
Medical Physician Assistant 363AM0700X PA031111 DC
Medical Physician Assistant 363AM0700X 3806 CT Primary

Addresses

Primary practice location

22 Pine St
New Canaan, CT 06840-5408

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

170 Mount Pleasant Rd
Newtown, CT 06470-1408
Phone (203) 426-1818

Other practice location 2

1001 G St NW
Suite 200 East
Washington, DC 20001-4545
Phone (202) 660-0005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171117001951 CT Practitioner - Physician Assistant 7416137948 Reassigns benefits to 1 organization
I20250505001757 NY Practitioner - Physician Assistant 7416137948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HHC One Medical, LLCGroup PAC ID 8820444060, 7 clinicians

Practice addresses (Care Compare)

104 Heights Rd
Suite R103
Darien, CT 06820-4119
Phone (888) 663-6331

22 Pine St
New Canaan, CT 06840-5408
Phone (888) 663-6331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA031111DCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741996800000",
    "number": "1013195551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PINE ST",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068405408",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Mount Pleasant Rd",
            "address_purpose": "LOCATION",
            "city": "Newtown",
            "state": "CT",
            "postal_code": "064701408",
            "country_code": "US",
            "telephone_number": "203-426-1818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 G St NW",
            "address_2": "Suite 200 East",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200014545",
            "country_code": "US",
            "telephone_number": "202-660-0005",
            "fax_number": "202-660-0025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "SUSAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2025-03-15",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0002509",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA031111",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "3806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Canaan, CT

Sources for this page

Verify at the official NPI Registry.